Demystifying Routine Labs #1-3: Creatinine And EGFR (my Absurd Videos)

[Dan W]

I thought it'd be nice to make a summary thread for each of the (simpler) blood markers to help people who are reading through their labs. But don't murder me if I only do a few, it turned out to be a lot more work than I expected.

So, for serum creatinine (the one on routine bloodwork), here's my intro:

And my followup to introduce the concepts around the eGFR number that's based on creatinine:

And the actual discussion of eGFR:


Optimal levels
As you probably can guess from the video, optimal serum levels are going to depend on the person's muscle mass, creatine intake, and other factors. But the 0.8-1.1 mg/dL "optimal level" I saw in Blood Chemistry and CBC Analysis seems like a reasonable "things are probably working well" number to me. They also mention >1.6 as being the "alarm" level.

Conventional interpretations of high levels
Combining the suggested problems from Life Extension, Quest, and LabCorp's guides: dehydration, creatine supplementation, renal disease / insufficiency with low glomerular filtration, high consumption of red meat, muscle diseases, urinary tract obstruction, reduced renal bloodflow, rhabdomyolysis.

Conventional interpretations of low levels
Combining the suggested problems from Life Extension, Quest, and LabCorp's guides: inadequate protein, decreased muscle mass, severe liver disease, small stature.

Additional conventional reading

• The AACC
• MedlinePlus
• Medscape

Peat-related influences on levels
Here's some factors that are particularly relevant to us Peat-heads:

• Thyroid function: it seems like thyroid function greatly affects creatinine levels, and generally in the direction you'd expect (more thyroid -> lower creatinine because of increased filtration rate in the kidneys). The detailed reasons look like they're underexplored and complicated.
• Light: I haven't looked into this, but I get the impression some light therapies can help the kidneys. See the "Kidney" category in Valtsu's terrifyingly huge spreadsheet for more.
• Hydration: I'd love to quantify how much people's hydration status affects creatinine. I think we have everyone from people living off milk/OJ to the Eat-for-Heat types who look suspiciously at anything that sloshes around. But I've only found a thirsty-bird study, so it's hard to tell how much this actually matters. Anyone have a better resource?
• Aspirin: I haven't looked into this in detail, but aspirin might raise levels (references for evidence in the elderly number 1 and number 2, and a vague possible mechanism). I wonder if this is one reason my levels were wonky for a while.
• Niacinamide (and phosphate management): see Haidut's thread on niacinamide for kidney health.
• Oxidative stress and inflammation: I'm out of my depth on this, but I get the impression the biggest factors in kidney function decreasing with age are oxidative stress and inflammation. Which I suppose is not surprising.

Further testing

• For people really digging deep into kidney function, it sounds like a newer test that measures "Cystatin C" might be superior at identifying kidney issues with less ambiguity, and might be especially useful when combined with creatinine. Health Tests Direct is the cheapest source I know of at $56.
• There's an easy way to resolve that ambiguity about whether creatinine levels are high because of a lot of production, or because the kidneys aren't filtering it. It's called a "creatinine clearance" test, and involves collecting your urine for comparison between the amount of creatinine in it and in the blood. The cheapest provider I've seen is RequestATest at $59 (if you choose LabCorp).
• There are urine creatinine test strips (like these), but I haven't seen any that are very sensitive.

Please let me know any feedback or suggestions, positive or negative. For all I know I've made 27 mistakes in the post/video without realizing it.

 

[Westside PUFAs]

Dan Wich Thug Life

 

[Dan W]

Dan Wich Thug Life

While editing the video I quickly realized there's no single frame where I don't have a ridiculous expression:

 

[raypeatclips]

Fantastic video, I hope you make more of these.

 

[lollipop]

Great. Appreciating the learning with the humor...

 

[Herbie]

Show those dogs who's in charge

 

[Lilac]

Amazing job for a first effort. Monty Python-esque visuals. You are very talented!

 

[NathanK]

Great job! It was very informative and entertaining. I like how you started this with creatinine of all things. My amount of muscle is probably why my levels have always been at the top of the range.

Btw, Ive taken creatine in the past and it took my creatinine way out of lab range. My doctor told me I should pull back on taking it (granted I had done a 10g/day week loading phase prior to labs).

 

[SQu]

Great idea, thank you! Look forward to the next one, and yes, I have that kidney problem you listed that's from pausing the video to read fast scrolling titles.

 

[Dan W]

Thanks for the kind words, everyone.

Show those dogs who's in charge

I saw that clipart dog with the appalled expression and knew I had to use him somehow.

Btw, Ive taken creatine in the past and it took my creatinine way out of lab range. My doctor told me I should pull back on taking it (granted I had done a 10g/day week loading phase prior to labs).

Interesting. To my interpretation, the worst the creatine was doing was making the creatinine test useless for identifying kidney problems.

I've been curious to figure out whether creatinine does *anything* harmful at levels that aren't approaching total kidney failure. I can't even find anything specific to creatinine in stage 5 kidney disease, just general lists of symptoms patients might encounter.

I need to organize my notes better, I think I might've been taking (modest) amounts of creatine during one or two of my tests, so it might explain some of my fluctuation.

I have that kidney problem you listed that's from pausing the video to read fast scrolling titles.

I'm afraid there's no known cure

 

[NathanK]

I've been curious to figure out whether creatinine does *anything* harmful at levels that aren't approaching total kidney failure. I can't even find anything specific to creatinine in stage 5 kidney disease, just general lists of symptoms patients might encounter.

There might be more info if you search "light chain deposition disease". Light chains increase and destroy kidneys, which dramatically increases creatinine. Often LCD turns into multiple myeloma. It can also be called light chain myeloma if you need another search term.

High creatinine is a hallmark marker of renal disease, but im with you in that I dont know if creatinine is actually harmful in itself.

 

[sweetpeat]

Thanks for posting this! It's very informative and helpful. I never paid much attention to creatinine levels on my lab work before because it was always in range. But now that I know there's an optimal range I will pay more attention. My recent lab work came out slightly under optimal (0.77) and some of my liver enzymes were slightly elevated. I'm thinking this points to inadequate protein. I tend to struggle to eat enough and I think I really let my protein intake slide over the summer. I'm going to work on getting adequate protein and see if I can optimize those numbers.

 

[Dan W]

I've added my followup video to the original post, I'll also toss my eGFR video in this same thread when it's done.

 

[lepetitcheval]

I thought that this was excellent. Thank you Dan.

 

[ddjd]

Why do you say they're dumb? You don't need to play the self depricating card Dan, they're good videos

 

[Dan W]

Well thank you both. And Joeyd, I'm just accounting for my attempts to come up with enough jokes to make them entertaining, eventually resorting to things I would've found hilarious in 2nd grade :)

 

[Dan W]

I've added the third one to the initial post. I can't say it's the most educational of the three, but I tried to make the boring subject entertaining.

 

[sladerunner69]

I thought it'd be nice to make a summary thread for each of the (simpler) blood markers to help people who are reading through their labs. But don't murder me if I only do a few, it turned out to be a lot more work than I expected.

So, for serum creatinine (the one on routine bloodwork), here's my intro:

And my followup to introduce the concepts around the eGFR number that's based on creatinine:

And the actual discussion of eGFR:


Optimal levels
As you probably can guess from the video, optimal serum levels are going to depend on the person's muscle mass, creatine intake, and other factors. But the 0.8-1.1 mg/dL "optimal level" I saw in Blood Chemistry and CBC Analysis seems like a reasonable "things are probably working well" number to me. They also mention >1.6 as being the "alarm" level.

Conventional interpretations of high levels
Combining the suggested problems from Life Extension, Quest, and LabCorp's guides: dehydration, creatine supplementation, renal disease / insufficiency with low glomerular filtration, high consumption of red meat, muscle diseases, urinary tract obstruction, reduced renal bloodflow, rhabdomyolysis.

Conventional interpretations of low levels
Combining the suggested problems from Life Extension, Quest, and LabCorp's guides: inadequate protein, decreased muscle mass, severe liver disease, small stature.

Additional conventional reading

• The AACC
• MedlinePlus
• Medscape

Peat-related influences on levels
Here's some factors that are particularly relevant to us Peat-heads:

• Thyroid function: it seems like thyroid function greatly affects creatinine levels, and generally in the direction you'd expect (more thyroid -> lower creatinine because of increased filtration rate in the kidneys). The detailed reasons look like they're underexplored and complicated.
• Light: I haven't looked into this, but I get the impression some light therapies can help the kidneys. See the "Kidney" category in Valtsu's terrifyingly huge spreadsheet for more.
• Hydration: I'd love to quantify how much people's hydration status affects creatinine. I think we have everyone from people living off milk/OJ to the Eat-for-Heat types who look suspiciously at anything that sloshes around. But I've only found a thirsty-bird study, so it's hard to tell how much this actually matters. Anyone have a better resource?
• Aspirin: I haven't looked into this in detail, but aspirin might raise levels (references for evidence in the elderly number 1 and number 2, and a vague possible mechanism). I wonder if this is one reason my levels were wonky for a while.
• Niacinamide (and phosphate management): see Haidut's thread on niacinamide for kidney health.
• Oxidative stress and inflammation: I'm out of my depth on this, but I get the impression the biggest factors in kidney function decreasing with age are oxidative stress and inflammation. Which I suppose is not surprising.

Further testing

• For people really digging deep into kidney function, it sounds like a newer test that measures "Cystatin C" might be superior at identifying kidney issues with less ambiguity, and might be especially useful when combined with creatinine. Health Tests Direct is the cheapest source I know of at $56.
• There's an easy way to resolve that ambiguity about whether creatinine levels are high because of a lot of production, or because the kidneys aren't filtering it. It's called a "creatinine clearance" test, and involves collecting your urine for comparison between the amount of creatinine in it and in the blood. The cheapest provider I've seen is RequestATest at $59 (if you choose LabCorp).
• There are urine creatinine test strips (like these), but I haven't seen any that are very sensitive.

Please let me know any feedback or suggestions, positive or negative. For all I know I've made 27 mistakes in the post/video without realizing it.

Lol please tell me why did "some letters" want to make peeing in the cup for a kidney test more sexy? It just seems like an odd choice in words...

 

[Dan W]

Lol please tell me why did "some letters" want to make peeing in the cup for a kidney test more sexy?

I love how baffling your sentence is without context. If I remember right, she was saying it in a marketing sense, like making it more appealing/fun to screen for kidney problems.

 

[Brother John]

I thought it'd be nice to make a summary thread for each of the (simpler) blood markers to help people who are reading through their labs. But don't murder me if I only do a few, it turned out to be a lot more work than I expected.

So, for serum creatinine (the one on routine bloodwork), here's my intro:

And my followup to introduce the concepts around the eGFR number that's based on creatinine:

And the actual discussion of eGFR:


Optimal levels
As you probably can guess from the video, optimal serum levels are going to depend on the person's muscle mass, creatine intake, and other factors. But the 0.8-1.1 mg/dL "optimal level" I saw in Blood Chemistry and CBC Analysis seems like a reasonable "things are probably working well" number to me. They also mention >1.6 as being the "alarm" level.

Conventional interpretations of high levels
Combining the suggested problems from Life Extension, Quest, and LabCorp's guides: dehydration, creatine supplementation, renal disease / insufficiency with low glomerular filtration, high consumption of red meat, muscle diseases, urinary tract obstruction, reduced renal bloodflow, rhabdomyolysis.

Conventional interpretations of low levels
Combining the suggested problems from Life Extension, Quest, and LabCorp's guides: inadequate protein, decreased muscle mass, severe liver disease, small stature.

Additional conventional reading

• The AACC
• MedlinePlus
• Medscape

Peat-related influences on levels
Here's some factors that are particularly relevant to us Peat-heads:

• Thyroid function: it seems like thyroid function greatly affects creatinine levels, and generally in the direction you'd expect (more thyroid -> lower creatinine because of increased filtration rate in the kidneys). The detailed reasons look like they're underexplored and complicated.
• Light: I haven't looked into this, but I get the impression some light therapies can help the kidneys. See the "Kidney" category in Valtsu's terrifyingly huge spreadsheet for more.
• Hydration: I'd love to quantify how much people's hydration status affects creatinine. I think we have everyone from people living off milk/OJ to the Eat-for-Heat types who look suspiciously at anything that sloshes around. But I've only found a thirsty-bird study, so it's hard to tell how much this actually matters. Anyone have a better resource?
• Aspirin: I haven't looked into this in detail, but aspirin might raise levels (references for evidence in the elderly number 1 and number 2, and a vague possible mechanism). I wonder if this is one reason my levels were wonky for a while.
• Niacinamide (and phosphate management): see Haidut's thread on niacinamide for kidney health.
• Oxidative stress and inflammation: I'm out of my depth on this, but I get the impression the biggest factors in kidney function decreasing with age are oxidative stress and inflammation. Which I suppose is not surprising.

Further testing

• For people really digging deep into kidney function, it sounds like a newer test that measures "Cystatin C" might be superior at identifying kidney issues with less ambiguity, and might be especially useful when combined with creatinine. Health Tests Direct is the cheapest source I know of at $56.
• There's an easy way to resolve that ambiguity about whether creatinine levels are high because of a lot of production, or because the kidneys aren't filtering it. It's called a "creatinine clearance" test, and involves collecting your urine for comparison between the amount of creatinine in it and in the blood. The cheapest provider I've seen is RequestATest at $59 (if you choose LabCorp).
• There are urine creatinine test strips (like these), but I haven't seen any that are very sensitive.

Please let me know any feedback or suggestions, positive or negative. For all I know I've made 27 mistakes in the post/video without realizing it.

Dan, Great Contribution!
Thanks!
Brother John